What is Social Marketing?
Social marketing takes the thinking used in commercial marketing to influence customer behaviour and applies it health and social behaviours. It can prompt a target audience to voluntarily accept, reject, modify or abandon a behaviour for the benefit of individuals, groups or society as a whole. In public health words, it can address the prevention paradox. Social marketing uses techniques like branding and segmentation that have been successfully used to get us to drink Absolut, smoke Marlboro and drive SUVs and apply them to get us to drink sensibly, preserve our lungs and walk to work.
At the onset, social marketing is about knowing your audience. Message awareness does not equal change. Social marketing goes beyond mass media campaigns and involves interpersonal and policy development. Behaviours need to be sold. Just like commercial marketers who pitch their products against those of their competitors, the social marketer competes with the audience's current behaviour. The main principle for marketing health is that health products should be tangible, attractive and accessible. Unfortunately, much of health is intangible and access can be limited. For example, a lack of green spaces in urban areas makes exercise difficult. As for attractiveness, well, health promotion has long been dogged with an image of leaflets telling us what we cannot and should not do that health promotion goals do not look appealing to the average consumer!
Planning Your Social Marketing Campaign
One of the strengths of social marketing is that it is committed to systematic programme planning. The first stage - sometimes called 'Project scoping' - involves understanding the consumer. Consumers are not homogenous. You need to know about current behaviour and attitudes. What are their reasons for resistance? What do they believe to be true? Should you use a formal approach (research) to finding out or informal (brainstorming, talking to frontline staff)? It may be worth doing a health needs assessment to uncover the main characteristics of individuals and communities prior to designing the programme. An interesting grid I have come across divides the audience into four categories:
- the well-informed and concerned
- the uninformed and concerned
- the uninformed and unconcerned
- the well informed but unconcerned
For the first group (the well-informed and concerned), the type of message you would use would be to update their knowledge. For the second group, you would educate. For the third group (the uninformed and unconcerned) you would shock and show and for the last group, you would shock and shame. 'Don't drink and drive' television advertisements frequently fall into this last group. We all know the dangers of drinking and driving yet people continue to do so. The adverts shame by displaying the adverse consequences and the remorse of the driver. In this first stage, it is also good to engage internal and external stakeholders. In particular, communications teams should be involved from the start. Often, NHS players have a habit of just asking communications departments to design a poster or a leaflet instead of utilising their skills in the development of the programme.
The second and third stages of a social marketing programme consist of the strategy formulation and implementation plans. Key here is the emphasis on the desired response in the audience's current attitudes and behaviours. You need to target them! Channel approach, timing, tone and style are all important. Preventive behaviour will not occur if the anticipated costs of acting outweigh its perceived benefits - for instance, parking one's car before using a mobile costs time and effort. Finally, the programme should have success indicators which can be evaluated in the fourth and final stage of a social marketing programme, the evaluation stage.
Experience Trumps Advertisement
One thing to note is that direct/personal experience of a brand or a service will always upstage the medium (e.g. advertisement). For example, there is no point in banks pumping money into television campaigns about how great their services are when the average customer encounters queues and poor customer service in their local branch. Vivid experiences are most remembered. Advertising at best will raise mild interest. To combat this problem, three zones to contend with have been identified. In the centre of the zone map is the inner core called the 'Zone of Intimacy'. This is where the individual personally experiences a product or service and includes service delivery, the distribution of a product, ingredients, packaging, atmosphere etc. Surrounding this zone is the 'Zone of Discovery', which involves the wider community of an individual, e.g. the sampling of goods, celebrity usage, word of mouth, etc. The outer circle is the 'Zone of mediation', the mass campaign zone, e.g. the corporate website, public relations, TV advertising, press advertising, celebrity endorsement. Most of the time, people pour money into this outer circle with minimal returns. It would be more effective and cost-effective to work from the inner circle out.
Use of the 'Zones of perception' can be readily illustrated in a health service example such as promoting MMR uptake. The audience are parents of children. Starting with the 'Zone of Intimacy', efforts should be focused on making GP practices a desirable place to get vaccinations (the premise being that a parent is less likely to uptake MMR if s/he has experienced cancelled appointments, waiting lists or grumpy staff). Atmosphere, feel of the place, child friendliness, attitude of staff, sensation of injection could be addressed as they all affect how people view MMR. Make sure that staff in GP surgeries are knowledgable about MMR, perhaps have MMR mornings or have a mobile MMR, taking it out of the surgery and to the people. It is worth getting the 'Zone of Intimacy' right as this leads to good word of mouth. For the 'Zone of Discovery', working with health visitors, post natal clinics, one o'clock clubs, celebrity usage can be harnessed. Speakers can be introduced into local clubs/community centres/groups. You could give out t-shirts to the first 100 babies who are vaccinated or have an MMR month, covered on local radio or by local newspapers. This should create a local buzz. With most of the efforts gone into the first two zones, less effort is needed in the third. This however can include an overall (national) MMR campaign and working with the media to support interpersonal initiation.
How do you evaluate impact of social marketing campaigns in public health?
Social marketing is increasing being used to promote health improvement and health protection activities. Use of social media is being increasing used by public health professionals to raise awareness of public health issues, including Public Health England's 'One You' Campaign. Yet to know if these social marketing and social media interventions are having any impact, we need to be able to evaluate the impact. This can be difficult for uses of social media, where your impact is linked to your reach and whethe or not you have managed to influence the key influencers in your target population.
Before embarking on your evaluation, be mindful of the Customer Choice Process:
Doing the Evaluation
Evaluation of social marketing campaigns are usually of a mixed methods design, such as online survey, followed up by focus groups for greater insight and observations.
Stages of the Evaluation
- Formative research - what affects target behaviour? What is the message? What is the predicted outcome?
- Process evaluation - how is the message delivered? Tjhink the 4 Ps!
- Place - what materials are being disseminated? what is the distribution?
- Product - what beliefs and behaviours are changing? are messages understood? what is needed next?
- Price - what are barriers to change? is the behavour inconvenient, hard to do?
- Promotion - how aware is the audience? are there unexpected outcomes? what is the demand for materials, programmes or messages? is there diffusion in the message to other audiences?
- Message testing - how do respondents respond to the message?
- Outcome evaluation - what are the behavioural effects of the message on the audience?
- Impact evaluation - what is the long term effect of the message on health promotion and disease prevention?